Severe vocal cord dysfunction resistant to all current therapeutic interventions

Area of Science:

• Respiratory Medicine
• Otolaryngology

Background:

• Vocal cord dysfunction (VCD) involves paradoxical vocal cord adduction, leading to wheezing, stridor, cough, and dyspnea.
• VCD is frequently misdiagnosed as refractory asthma, despite coexisting possibilities.
• VCD significantly impacts daily activities and is challenging to manage therapeutically.

Observation:

• A case study of a patient with severe VCD is presented.
• The patient underwent various therapeutic interventions, including intralaryngeal botulinum toxin injections.
• Despite these interventions, treatment failed to resolve the condition.

Findings:

• Intralaryngeal botulinum toxin injection was ineffective in treating this severe VCD case.
• The patient's VCD was refractory to all available therapeutic options.
• The ultimate outcome for the patient was the necessity of a permanent tracheostomy.

Implications:

• This case highlights the challenges in diagnosing and treating VCD, especially when refractory to standard and advanced therapies.
• It underscores the potential for severe, life-altering outcomes in refractory VCD cases.
• The case may prompt further research into alternative or more effective VCD treatment strategies.